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Google Co-Founders on Healthcare: “Thanks, But No Thanks”

thehealthcareblog.com

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Re: Google Co-Founders on Healthcare: “Thanks, But No Thanks”

#61

Post by laurenstill »

lostcolony wrote: post #53
totoroisalive wrote: post #7

Earlier quoted context omitted.

The whole mining data on health has so many wonderful possibilities, but giving so much of my privacy it's a big no for me.

As a kind of note and response to all of your other responses, the issue isn't actually anonymization, but being able to correlate it with other data. That is, if health data were anonymized, and was done right, and was made unable to be correlated with any other data, it likely would be sufficient. It's when you start allowing it to be correlated with personally identifiable things that it ceases to be anonymous. Th…

You both may be interested in this paper: Publishing data from electronic health records while preserving privacy: A survey of algorithms

http://webcache.googleusercontent.com/search?q=cache:1gHT-y0...

Re: Google Co-Founders on Healthcare: “Thanks, But No Thanks”

#62

Post by famousactress »

laurenstill wrote: post #59
zmmmmm wrote: post #45

Earlier quoted context omitted.

I'm not saying you don't need to understand the regulations and law - you absolutely do. But you do have an advantage in being able to be less conservative and more innovative in how you interpret them. For examples, take Uber and AirBnb - they are both pushing the boundaries of highly regulated industries. An existing hotel chain couldn't do it because they have too much to lose, and target such broad markets. But a…

I'd argue they are at disadvantage. Small startups can't eat the cost of spending 2 years developing for a particular standard just to have it changed on the due date.

That's a fair argument but in practice isn't true. The pace at the larger health IT shops is FUCKING GLACIAL. I've been through getting an EMR through two meaningful use stages in a fifth the time combined than a typical larger shop might've gotten one done, with a tenth the manpower.

In verticals like this don't dismiss the advantage of being lean, nimble, and wholly stocked with incredible and enthusiastic people.

Re: Google Co-Founders on Healthcare: “Thanks, But No Thanks”

#63

Post by famousactress »

zmmmmm wrote: post #45
tn13 wrote: post #40

Earlier quoted context omitted.

It sounds very contradictory. In most of the heavily regulated industries such as healthcare or insurance, one of the economic efficiencies are a better understanding of the complex law, startups can not solve this inefficiency in their favor.

I'm not saying you don't need to understand the regulations and law - you absolutely do. But you do have an advantage in being able to be less conservative and more innovative in how you interpret them. For examples, take Uber and AirBnb - they are both pushing the boundaries of highly regulated industries. An existing hotel chain couldn't do it because they have too much to lose, and target such broad markets. But a…

This. This. This.

I wish more people saw healthcare this way, and I guess now I'll probably use Uber and AirBnb as an analogy to help them to. THIS is the way to think about health, and how to treat it's risks and limitations.

Re: Google Co-Founders on Healthcare: “Thanks, But No Thanks”

#64

Post by angersock »

justinph wrote: post #8

When you fuck up in health, people can die. Regulation exists for a reason.

Right, but unless you fuck up pretty badly software is not going to kill a patient directly (barring, say, pacemaker software).

We had to do a risk analysis review recently, and figured that unless you physically dropped one of our servers onto a patient you couldn't directly cause harm.

Anyways, you'd be a lot less concerned with regulation if you knew how brainfucked and unscientific the whole field of medicine seems to be--it's not as far along as you might expect/hope.

Re: Google Co-Founders on Healthcare: “Thanks, But No Thanks”

#66

Post by AnthonyMouse »

muzz wrote: post #49
kgarten wrote: post #34

Earlier quoted context omitted.

Why don't they just buy an island make their own country with their own rules?? ;)

Not sure who downvoted you, but this is indeed the essence of one of the counterpoints against regulation-- that if we regulate an industry, the innovation in that industry will simply occur elsewhere in the world, outside of US regulation.

That is generally true for things like minimum wage laws or regulations on manufacturing. If it is expensive to manufacture in the US then companies can easily manufacture in China.

It doesn't really work for healthcare because you can't remove it from the jurisdiction. It isn't practical to fly to another country to receive emergency medical services or if all you need is to fill a prescription. Meanwhile the customers with the wealth to sustain research into novel health products are in the countries that impose heavy regulatory burdens on anyone who wants to service them.

Re: Google Co-Founders on Healthcare: “Thanks, But No Thanks”

#67

Post by watwut »

lostcolony wrote: post #53
totoroisalive wrote: post #7

Earlier quoted context omitted.

The whole mining data on health has so many wonderful possibilities, but giving so much of my privacy it's a big no for me.

As a kind of note and response to all of your other responses, the issue isn't actually anonymization, but being able to correlate it with other data. That is, if health data were anonymized, and was done right, and was made unable to be correlated with any other data, it likely would be sufficient. It's when you start allowing it to be correlated with personally identifiable things that it ceases to be anonymous. Th…

Another interesting write up about anonymization https://freedom-to-tinker.com/blog/randomwalker/no-silver-bu...

tl;dr: it does not work much.

Re: Google Co-Founders on Healthcare: “Thanks, But No Thanks”

#68

Post by [deleted] »

greggman wrote: post #50
asdfologist wrote: post #36

I'm surprised the blog post mentions nothing about Google Health. Basically, Google has already tried this and failed. http://en.wikipedia.org/wiki/Google_Health

Failed seems like an unfair characterization. Another possibility is they thought it was a cool idea, then found out how regulated it was, how it would be nearly impossible to add any features without massive government oversight, and got out.

[deleted]

Re: Google Co-Founders on Healthcare: “Thanks, But No Thanks”

#69

Post by iskander »

greggman wrote: post #50
asdfologist wrote: post #36

I'm surprised the blog post mentions nothing about Google Health. Basically, Google has already tried this and failed. http://en.wikipedia.org/wiki/Google_Health

Failed seems like an unfair characterization. Another possibility is they thought it was a cool idea, then found out how regulated it was, how it would be nearly impossible to add any features without massive government oversight, and got out.

I was an intern on the Google Health team and witnessed many problems unrelated to external barriers.

1) The original codebase was a nightmarish mess of Java/GWT code that did very little (my first real-life encounter with a FactoryFactory). Most of the developers from this first version drifted away from the project and by the time I arrived there was a second team who were talented, but, unfortunately spent much of their time slowly refactoring other people's crappy code.

2) I didn't observe very much clear product vision. Instead, we had a paranoid obsession with matching the features of Microsoft Health Vault (which was equally meandering & useless).

3) There was a huge top-down pressure from Marissa M and other high level managers to make Google Health into something astoundingly successful, suffocating any possibility of incremental progress and disempowering the actual developers.

4) We had one MD on staff and very little other experience with medicine or healthcare. The developers were very far from the problem domain and relying on a game of managerial telephone to ascertain what the current state of medical record management is and what improvements are possible.

Anyway, in short, my experience was that Google screwed up.

Re: Google Co-Founders on Healthcare: “Thanks, But No Thanks”

#70

Post by Dakuan »

totoroisalive wrote: post #7
ericd wrote: post #4

Basically, he's saying that it's too heavily regulated for them to want to dip their toe in. Seems reasonable, it's the same reason I never bothered with the healthcare ideas I've been interested in. Too many landmines, and not enough latitude to try creative things.

The whole mining data on health has so many wonderful possibilities, but giving so much of my privacy it's a big no for me.

We had a big old flap about this in the UK recently http://www.theguardian.com/society/2014/jun/17/nhs-patient-d...
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